Can sodium MRI be used as a method for mapping of cartilage stiffness?
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RESEARCH ARTICLE
Can sodium MRI be used as a method for mapping of cartilage stiffness? Sander Brinkhof1 · Martijn Froeling1 · Rob P. A. Janssen2,3,4 · Keita Ito4,5 · Dennis W. J. Klomp1 Received: 1 April 2020 / Revised: 19 September 2020 / Accepted: 23 October 2020 © The Author(s) 2020
Abstract Objective Sodium concentration is responsible for (at least part of) the stiffness of articular cartilage due to the osmotic pressure it generates. Therefore, we hypothesized that we could use sodium MRI to approximate the stiffness of cartilage to assess early cartilage degeneration. Methods Four human tibial plateaus were retrieved from patients undergoing total knee replacement (TKR), and their cartilage stiffness mapped with indentation testing, after which samples were scanned in a 7 T MRI to determine sodium concentration. The relation of biomechanical parameters to MRI sodium and glycosaminoglycan (GAG) concentration was explored by a linear mixed model. Results Weak correlations of GAG concentration with apparent peak modulus (p = 0.0057) and apparent equilibrium modulus (p = 0.0181) were observed and lack of correlation of GAG concentration versus MRI sodium concentration was observed. MRI sodium concentration was not correlated with apparent peak modulus, though a moderate correlation of MRI sodium concentration with permeability was shown (p = 0.0014). Discussion and conclusion Although there was correlation between GAG concentration and cartilage stiffness, this was not similar with sodium concentration as measured by MRI. Thus, if the correlation between MRI sodium imaging and GAG concentration could be resolved, this strategy for assessing cartilage functional quality still holds promise. Keywords MRI · Cartilage · Stiffness · Sodium
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s10334-020-00893-x) contains supplementary material, which is available to authorized users. * Sander Brinkhof [email protected] 1
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
2
Department of Orthopaedic Surgery and Trauma, Maxima Medisch Centrum, Eindhoven, The Netherlands
3
Fontys University of Applied Sciences, Eindhoven, The Netherlands
4
Orthopaedic Biomechanics, Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
5
Department of Orthopaedics, University Medical Center Utrecht, Utrecht, The Netherlands
Focal cartilage defects are often treated with regenerative medicine therapies, because the body cannot heal these defects itself due to the sparsely distributed chondrocytes throughout the articular cartilage and its avascular nature. Patients with focal cartilage defects suffer from pain and functional impairment, which significantly affects their quality of life [1]. Early identification of these focal cartilage defects is important, since it improves the prognosis and outcome of treatment [2, 3]. Arthroscopy has shown to be an excellent m
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